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Individual

DR. HARIKA RAO MENDU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1780 OLD HIGHWAY 50 E STE 102, UNION, MO 63084-3397
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2020035764
MO
1223G0001X
General Practice Dentistry
DS042234
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
400090529
MO
Enumeration date
06/18/2019
Last updated
09/12/2022
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